Hazards magazine, number 98, April-June 2007

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Cartoon: Andy Vine



Government says work is good for you
– even when it’s not

Not good

The government is clear its new preoccupation with “good work” is part and parcel of its desire to reduce the benefits bill. But when the Health and Safety Executive backs a strategy that includes unhealthy workplace advice and plays down the impact of bad work, alarm bells really start to ring. Hazards editor Rory O’Neill says it’s a good news story that makes no sense.

Click on image for larger version

Talking about “good work” is not a bad thing, and the government is doing a lot of this talk at the moment. But after several months extolling the health giving properties of good work, it is now asking what exactly this means.

In February new DWP minister Lord McKenzie posed the question to businesses, government and charities. “We know that good work is beneficial for individuals, communities, and the economy,” he said. “But we need to figure out exactly what 'good work' is, so that we can ensure workplaces are happy, healthy and productive. This may necessitate a radical rethink, including addressing outdated work practices, increasing flexible working, cutting red tape, and promoting effective and open work cultures.”

The minister added: “Positive changes will reduce the number of days lost to ill health and injury, and allow people to remain in and return to work quicker. A collective effort is essential to achieve this - government must work alongside businesses, charities and healthcare professionals.”

A 27 February news release, carrying HSE, DWP and Department of Health logos, explained: “Evidence shows that work is beneficial to physical and mental health, and leads to greater social and financial inclusion. But it must be 'good work', for which there is no widely accepted understanding or definition, despite considerable presumed knowledge.”

It added that the government’s ‘Health, work and well-being strategy’ (Hazards 93) “reflects the government’s welfare reform agenda which is committed to helping more people enter into, remain in and return to work. The agenda aims to reduce the number of people who need to rely on incapacity benefits by 1 million, and help 1 million older workers and more than 300,000 lone parents into work.”

Whose benefit?

Professor Andy Watterson is critical of the strategy, saying the government is “missing the gorilla in the living room”.

The head of Stirling University’s Occupational and Environmental Health Research Group, told Hazards: “The two factors most clearly associated with ‘good work’ are missing from the strategy. The first is control over the job, and this means workers having real influence over how the job is designed, from content, to work pace, to work organisation, to the working environment.

“The second is proper health and safety standards, properly enforced. The government is asking business, charities and health professionals but not workers what they think, so is failing on the first count. And health and safety inspections, prosecutions and the number of safety inspectors are all plummeting, so it is failing on the second count too.” He added that contrary to DWP’s assertion, there is considerable evidence of what constitutes good work, but this means dealing with precisely the factors – work volume and speed, worker control and influence, work content and job security – that neither the Health and Safety Executive nor DWP have shown any appetite for addressing.

The good work agenda is linked inextricably to the government drive to revise the benefits system, with targets to reduce those in receipt of the key work-related injury and ill-health and sickness benefits.

At the March launch of what he described as a comprehensive review of the health of the working age population, work and pensions secretary John Hutton said the review will increase understanding of the beneficial link between work and health, and help identify where the greatest improvements can be made to the health of those who are in or want to return to work.

He said the review, to be led by national director for health and work Dame Carol Black, was important “not just to help change public perceptions about the links between work and health, but also to help us refine our approach and maximise the impact of the Health Work and Well-being Strategy”.

While the government admits it is uncertain what “good work” actually entails, it is already making fundamental policy decisions on the basis of hotly contested evidence it says supports the strategy. Ministers point to a September 2006 ‘Is work good for your health and well-being’ paper prepared for DWP and which played down the harmful effects of work (Hazards 96). Even so, it concluded that for 10-20 per cent of workers, work made their health worse – and this was a net loss, more than offsetting any positive effects.

By the time the document emerged in brochure form, endorsed by among others DWP, HSE, insurers, insurance lawyers and employers’ organisations, the original report’s conclusion that up to one in every five workers could have their health damaged by work had disappeared.

Neither the strategy nor the brochure has been endorsed by TUC or any trade union. And after more than six months in post, workplace health czar Dame Carole Black, who claimed she set out to talk to “everyone who could help the work health agenda,” had still to meet with a single trade union or workers’ advocacy organisation.

Looking crass

Commenting on the brochure, ‘Work and health; Changing how we think about common health problems’, Professor Watterson said: “It does not change the facts that occupational disease and injury take an enormous toll of UK workers but simply ignores such facts.

“This is an Alice in Wonderland document. If we don’t think about a problem – injury and disease at the workplace – it will disappear. In its fantasy world, flexibility and partnership will solve ‘most common health problems’. This is a seriously flawed and deeply misleading document.”

The brochure says these common health problems cause most sick leave, but says “they are not ‘severe’ in a medical sense”.

Sheffield University occupational health researcher Simon Pickvance commented that this “confuses what is severe in the medical sense of being life-threatening and what is severe in the sense of threatening livelihood. “Anxiety and depression caused by stress may not require referral to a psychiatrist but they can mean you have to leave your job. Ditto work-related upper limb disorders.” He says a list of “myths” in the publication are simplistic and sometimes plain wrong. Staying active might be good, as the brochure says, but for musculoskeletal disorders “all the clinical evidence states that removal from aggravating circumstances is the first step in management of these problems.”

In response to the claim that “work is therapeutic”, he says it can be “but in the case of stress we know that often it is not.” He adds that where employers are unwilling to sort out the root cause of work-related health problems the only alternative is to move jobs. “What help does the government give to people to move jobs? You have to be off work for six months to get Pathways to Work help, and there is no vocation guidance for adults worth the name.”

Professor Watterson shares Simon Pickvance’s concerns. “This document purports to challenge how we think about health at work and states that it dispels harmful myths about the hazards of work. It does no such thing. The evidence base for many of the statements it contains is flimsy if non-existent.” He added: “The rhetoric of this document is strong; its impact on improving working conditions will be minimal. It is an astonishingly simplistic piece of propaganda for a deeply flawed ideology that attempts to tippex work hazards and their impacts on UK employees out of the picture.

“I was surprised to find that the leaflet had not been endorsed by the cosmetics industry: it tries to cover up all the big issues of occupational ill health and injury in the UK but fails. Those who endorsed this junk document including HSE should be ashamed of themselves.”


Most reportable work accidents not reported

New research for the Health and Safety Executive suggests most legally-reportable workplace accidents, including major injuries, are not being reported. Researchers from the University of Liverpool interviewed 581 patients at the Royal Liverpool University Hospital who had suffered reportable work-related injuries and found only 30 per cent of reportable accidents to employees were in fact reported. The situation was worse still for self-employed workers, where only 2 of the 15 reportable injuries (13 per cent) were reported. HSE had previously thought reporting rates were higher, at about the 50 per cent mark.

Under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR), employers, the self-employed and anyone in control of work premises should report deaths, major injuries or any other injury leading to three days or more away from work. The researchers found however: “The main reason accidents were reported was time lost from work; other reasons for reporting accidents (major injuries, 4 or more days on reduced duties) were largely ignored.”

In the light of the findings, retail union Usdaw advised its union reps to: Ensure that accidents are both properly reported and notified by members; investigate workplace accidents; and receive and retain information relating to workplace accidents.

An investigation of reporting of workplace accidents under RIDDOR using the Merseyside Accident Information Model, HSE Research Report RR528, 2007. more


Small firms don’t get occupational health services

Workers in small firms rarely have access to occupational health services but rarely take sick leave either, a business survey has found. Survey responses from nearly 4,000 members of the Federation of Small Businesses (FSB) revealed 43 per cent of firms had not experienced any sickness absence in the past twelve months. They indicated this was down to good management and the loyalty that a small family firm can engender.

The survey also found providing cover for sick workers “can significantly reduce the perceived impact of sickness absence on productivity and staff morale.” Barely one in 20 of the respondents (6.5 per cent) provided access to occupational health services. The FSB report concludes that small businesses “need incentives to enable them to promote healthy workplaces and provide occupational health support to their staff.” It says “an important part of this is reduced Employers’ Liability Compulsory Insurance (ELCI) premiums in return for good workplace health and safety practices.”

The survey report adds that the government needs to do more to get the message out about support available to small firms. And GPs need more effective training in occupational health so they can provide better advice, the report concludes.

Health matters: A small business perspective, FSB:


Bosses must protect employees’ health

The Health and Safety Executive (HSE) has warned local authorities to be proactive in identifying and addressing health and safety issues affecting their staff. The HSE alert comes after an employment tribunal involving Dundee City Council.

HSE says the legal duty to provide occupational health support for staff is outlined in laws including the Management of Health and Safety at Work Regulations. It had issued a legally binding improvement notice after finding the council had an inadequate management system and provisions in place to deal effectively with occupational health risks. The council appealed against the improvement notice at the employment tribunal in September 2006, but this upheld HSE's action.

Dundee City Council has since put into force a comprehensive action plan. HSE inspector David Steven said: “Following the Dundee Council decision other local authorities across Scotland can be in no doubt about their duty to provide health monitoring and provision for their staff on an ongoing basis. The appropriate use of occupational health expertise and resources is necessary to comply with statutory duties but will also help employers meet non-statutory principles such as reducing work related sickness absence.”

HSE says it has worked with other councils to introduce “a proactive approach to managing occupational health.” It points to South Lanarkshire Council, which had worked with trade unions to introduce a sickness absence approach which is not punitive, but which includes free physiotherapy for employees whether attending or absent from work, access to a comprehensive occupational health team and an employee support officer who deals with all absences due to psychological illness.

Pamela Forsyth, a personnel adviser at the council, said: “At a time when many organisations have taken a negative, punitive approach to managing employee absence, we have adopted a new, all encompassing and innovative approach, based around the themes of promotion of health and wellbeing; preventative support and assistance; work life balance; and support and assistance during absence.

“As a result we have one of the lowest absence rates of all Scottish local authorities. Our approach has huge potential for replication in other organisations.”

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